Solstice Benefits Your Preferred Benefit Provider Agenda History - - PowerPoint PPT Presentation

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Solstice Benefits Your Preferred Benefit Provider Agenda History - - PowerPoint PPT Presentation

Dec 09, 2023 328 likes •440 views

Solstice Benefits Your Preferred Benefit Provider Agenda History of Success Enrollment Sites & Network Our Values Statewide Standards of Excellence Open Access Member Experience No Provider Assignment

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SLIDE 1

Solstice Benefits

Your Preferred Benefit Provider

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SLIDE 2

Agenda

  • History of Success
  • Our Values
  • Standards of Excellence
  • Member Experience
  • Effortless Enrollment
  • Products
  • DMPO
  • Plus Plan 1
  • DHMO
  • 800
  • Vision
  • Clear 10
  • Enrollment Sites & Network
  • Statewide
  • Open Access
  • No Provider Assignment
  • No Capitation
  • Value Added-On Services
  • Clear 100
  • Hear USA
  • Prescription Discount
  • Lasik Vision Care
  • Implant Network

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SLIDE 3

History of Success

  • Our Values
  • Our values guide us in everything that we do
  • Member Experience
  • Dedicated Service
  • Proactive Member Outreaches
  • Extensive Call Center Training
  • 8:00am – 6:00pm EST Monday – Friday
  • Multilingual Staff
  • Language Line supporting over 170 languages
  • 24/7 automated system
  • Self-Service Tools at Your Fingertips
  • Member portal at MySolstice.net
  • ID Cards, Claims, and Benefits
  • FAQ and resources

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  • Standards of Excellence
  • Over 50 Awards for our focus on health

literacy, quality, service, innovation, standards, and workplace solutions

  • URAC Accredited
  • Google Rating of 4.5 Stars
  • Effortless Enrollment
  • Intuitive enrollment site(s)
  • Immediate individual account processing

available in real-time

  • ID#’s assigned in our system as soon as

enrollment is complete

  • Confirmation e-mail at completion of payment

process

  • Pay sites for ongoing payment
  • EZ Pay Option
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SLIDE 4

Plus Plan 1

  • DMPO – Plus Plan 1
  • Discount Medical Preferred Organization
  • Highlights of the plan
  • No claim submission
  • Set fee for service
  • General Dentistry at a co-pay/ Specialty at a 25% discount
  • Guaranteed to be a 20-40% discount off the provider UCR
  • Uses the Plus Plan Network of providers
  • In network only
  • FL Based
  • Evaluations available 1 per 6 months at a $0 co-pay
  • Routine cleanings available 1 per 6 months at a $0 co-pay
  • No primary dentist selection required
  • Cosmetic procedures (teeth whitening, bonding, and veneers) are included at a co-payment level
  • 25% discount for procedures not listed within schedule of benefits
  • Dedicated Website
  • https://enrollment.solsticebenefits.com/
  • Where you Referred by an Agent?
  • Sunshine Health– John Smith

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SLIDE 5

800 Plan

  • DHMO – 800 Plan
  • Dental Health Maintenance Organization
  • Highlights of the plan
  • Guaranteed to be a 20-40% discount off the provider UCR
  • General Dentistry at a co-pay/ Specialty at a 25% discount
  • In-network only
  • FL Based
  • Evaluations available 1 per 6 months at a $0 co-pay
  • Routine cleanings available 1 per 6 months at a $0 co-pay
  • No primary dentist selection required
  • Children can see their network Pediatric Dentist up to age 16
  • Cosmetic procedures (teeth whitening, bonding, and veneers) are included at a co-payment level
  • 25% discount for procedures not listed within schedule of benefits
  • Dedicated Website
  • https://enrollment.solsticebenefits.com/
  • Where you Referred by an Agent?
  • Sunshine Health– John Smith

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SLIDE 6

Enrollment Site

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  • Quick Resource Link
  • Enrollment Walk - through
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SLIDE 7

Clear 10 Vision

  • Vision – Clear 10
  • Available year round with commercial plans only (Plus Plan 1 and 800 plan)
  • The plans provide listed services at a co-pay.
  • Makes payments directly to the provider for services rendered

based on the Schedule of Benefits.

  • Providers submit claims using a HICFA 1500 Form
  • Exclusions/Limitations
  • Exams are (1) in a 12 month period
  • Benefit is for either Frames or Contact Lenses but not both
  • The member receives a 20% discount on services not listed on the schedule of benefits.

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SLIDE 8

Member Perks - Value Add-On Benefits

  • Clear Vision 100
  • Great for members who wish to extend their

vision benefits

  • HearUSA
  • Free Hear Screening
  • Discounts of 20% - 40% on hearing devices
  • Prescription
  • Save on nearly 99% of all commonly prescribed

medication

  • Lasik Vision Care
  • Receive 15% off standard pricing and 5% off

promotional pricing

  • www.SolsticeLasik.com
  • Implant Network

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SLIDE 9

Support

  • Contact Us
  • Customer Service Toll Free
  • Monday – Friday
  • 8am – 6pm EST
  • 1-877-760-2247
  • E-mail
  • Member Inquiries
  • Contact@solsticebenefits.com
  • Broker Inquiries
  • Sales@SolsticeBenefits.com
  • Chat
  • Visit SolsticeBenefits.com and click on “Contact” and elect the chat option
  • Available for members, providers, and you the broker/agent
  • Claims Address
  • P.O. Box 14009

Lexington, KY 40512

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SLIDE 10

Open Forum – Questions?

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